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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
Political development on the royal regime era : A perusal according to the standards of Alexis de Tocqueville
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Abstract: The researcher aims to highlight the historical frames of political development in royal regime era (1921-1949) and study its transitions on social-political aspect for the various periods during this consistent era of Iraq history. As some elements played an important role in shaping this era’s features ,as well as 2hat succeed it, which mainly affected the political progression’s configuration, such as : political culture role, social and cultural foundation, state policy essence and the unofficial institutions remarkable role in influencing public awareness and concerning it's relation to the state ,the clan and religious institutions. The researcher employed Alexis de Tocqueville’s evaluation criteria and indi

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Publication Date
Tue Aug 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating the performance of Inspector General office of the Ministry of health in accordance with normative people and people results for the European excellence model EFQM 2013
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Current research sought to evaluate the performance and results of employees in accordance with normative to people and people result for the European model of excellence EFQM 2013 quality management Foundation in the Inspector General's Office/Ministry of health, so as to pursue a modern and advanced management methods in evaluating performance and the performance of the Office's relationship with a citizen's life, since it takes him beyond the accepted service capabilities today, but it became budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and continuous improvement and development as well as The primary role of the

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating the performance of Inspector General Office of the Ministry of health in accordance with normative people and people results for the European excellence model EFQM 2013
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Abstract:

Current research has sought to apply the criteria of potential for altmizalaorbi model EFQM 2013 in assessing the performance of the Inspector General's Office/Ministry of health, so as to keep up with a modern and advanced management methods in the evaluation of performance, as well as to link performance to a citizen's life, and it takes him beyond the accepted service capabilities today, but of budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and development, as well as the constant quest for continuous improvement, is the spirit of the principle underpinning the European Foundation Quality managemen

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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Al-rafidain University College For Sciences ( Print Issn: 1681-6870 ,online Issn: 2790-2293 )
The Use of Logistic Regression Model in Estimating the Probability of Being Affected By Breast Cancer Based On the Levels of Interleukins and Cancer Marker CA15-3
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Breast cancer has got much attention in the recent years as it is a one of the complex diseases that can threaten people lives. It can be determined from the levels of secreted proteins in the blood. In this project, we developed a method of finding a threshold to classify the probability of being affected by it in a population based on the levels of the related proteins in relatively small case-control samples. We applied our method to simulated and real data. The results showed that the method we used was accurate in estimating the probability of being diseased in both simulation and real data. Moreover, we were able to calculate the sensitivity and specificity under the null hypothesis of our research question of being diseased o

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Publication Date
Mon Apr 01 2013
Journal Name
Jpcs
STUDY THE COMPARATIVE EFFECT BETWEEN CYPERUS ESCULENTUS SEEDS EXTRACT AND GENTAMICIN ON INDUCED ENDOMETRITIS IN MICE
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Objectives of this project were to study the effect of 60% crude alcoholic extract of the seeds of cyperus esculentuson induced endometritis in the mice . The plant of cyperus esculentuswas extracted by preparing Alcoholic extract 60% . One hundred microliters of saline containing Escherichia coli (104cfu) was used to induce endometritis, by a single intracervicallyinjection, and endometritis developed after 2 days from injection. The mice were divided into five groups, The first group were treated with alcoholic extract of cyperus esculentusextract 150mg/kg body weight, the second group was treated with a daily 3mg per kg body weight of gentamicin given intra peritoneal,The third group was treated by 75mg/kg of cyperus esculentusextract an

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Publication Date
Sat Jun 20 2020
Journal Name
Al-bahith Al-a'alami
Creativity in the television advertising message andits effectivenessin attracting the attention of the recipient
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eclaration has become today has an important and active and influential role in the recipient public life، and are concentrated advertising on the creativity component manufacture to attract his attention toward what to be announced from a variety products ، and is dominated by television commercials tempo and imagination، and display them a variety of ways catches the attention and an impressive simulates the their senses of hearing and sight ، to influence in the receiver and the public paid for purchase. Through it crystallization the subject of our research on the importance of creativity in television advertising and effective for attracting the attention of the public towards the receiver advertised products، and in

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Publication Date
Sat Sep 30 2023
Journal Name
Al–bahith Al–a'alami
The Palestinian Elite's Use on Digital Diplomacy in the Face of the Israeli Narrative
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This study aims to determine the extent to which Palestinian elites use digital diplomacy to confront the Israeli narrative by exploring the motives for usage, patterns, essential digital diplomatic tools, and achieved satisfactions. The study adopted a survey methodology and employed a questionnaire distributed to a sample of 110 Palestinian political and media elites.
The study arrived at several key findings, including: Palestinian elites allocate a substantial (%67) of their efforts towards employing digital diplomacy as a response to the Israeli narrative. The foremost platforms employed for this purpose are Facebook and Twitter. The primary motivation for utilizing these digital platforms is to present

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The artistic treatment of the expatriate character in the fictional film: آسيا جبار خلف
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Although cinema is moving towards art, it has dealt with the character since the beginning of the discovery of cinematic art in films such as (Doctor Caligari's cabin) and most German expressive films in the third decade of the twentieth century, but the interest of cinema is growing in the estranged human personality, meaning that this character It lives by its alienation from the environment and society that surrounds it, because our present days have witnessed on the material and moral level more social breakdowns such as wars and disasters, and the sharp contradiction in the social and economic level of people themselves or between different societies, or between the individual and his community, and new social relations have increas

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Publication Date
Sun Mar 17 2019
Journal Name
Biochemical & Cellular Archives
EVALUATION OF THE POTASSIUM AVAILABILITY IN THE SALINE SOILS USING THE TRADITIONAL CHEMICAL CRITERION
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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Planner And Development
The Quantitative Analysis To Assess The Efficiency Of The Transport Network In Sader City
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     This research examines the quantitative analysis to assess the efficiency of the transport network in Sadr City, where the study area suffers from a large traffic movement  for the variability of traffic flow and intensity at peak hours as a result of inside traffic and outside of it, especially in the neighborhoods of population with  economic concentration.                                                           &n

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